Laser extraction of entrapped leads

Removing entrapped pacing and defibrillator leads has been greatly simplified by making use of the excimer laser extractor. Sixty-two leads were successfully removed, although where appropriate, portions of the lead remained in place in 10 cases. There were two serious complications, one tear of the superior vena cava during an ICD extraction and one tear of the atrium during an atrial lead extraction. Both were controlled successfully through emergency sternotomy. Although extracting entrapped leads has been much simplified by making use of the laser extractor, the process is not free of serious complications. Those involved in explanting leads should be aware of the outcomes and be prepared for emergent management.

Dosimetric implications of atmospheric dispersal of tritium near a heavy-water research reactor facility

An estimate of the tritium dose to the public in the vicinity of the heavy water research reactor facility at AECL-Chalk River Laboratories, Ontario, Canada, has largely been accomplished from analyses on regularly-collected samples of air, precipitation, drinking water and foodstuffs (pasture, fruit, vegetables and milk) and environmental dose models. To increase the confidence with which public doses are calculated, tritium doses were estimated directly from the ratio of tritiated species in urine samples from members of the general public. Single cumulative 24 h urine samples from a few adults living in the vicinity of the heavy-water research reactor facility at Chalk River Laboratories, Canada were collected and analysed for tritiated water and organically bound tritium. The participants were from Ottawa (200 km east), Deep River (10 km west) and Chalk River Laboratories. Tritiated water concentrations in urine ranged from 6.5 Bq.l-1 for the Ottawa resident to 15.9 Bq.l-1 for the Deep River resident, and were comparable to the ambient levels of tritium-in-precipitation at their locations. The ultra-low levels of organically bound tritium in urine from these same individuals were measured by 3He-ingrowth mass spectrometry and were 0.06 Bq.l-1 (Ottawa) and 0.29 Bq.l-1 (Deep River). For Chalk River Laboratories workers, tritiated water concentrations in urine ranged from 32 Bq.l-1 to 9.2 x 10(4) Bq.l-1, depending on the ambient levels of tritium in their workplace. The organically bound tritium concentrations in urine from the same workers were between 0.08 Bq.l-1 and 350 Bq.l-1. With a model based on the ratio of tritiated water to organically bound tritium in urine, the estimated dose arising from organically bound tritium in the body for the Ottawa and Deep River residents was about 26% and 50%, respectively, of the body water tritium dose. The workers in a reactor building at Chalk River Laboratories had less than 10% dose contribution from organically bound tritium, but had higher overall tritium dose due to frequent intakes of tritiated water vapour in the workplace. The results of this study suggest that most of the tritium dose to workers at Chalk River and general population near Chalk River is the result of tritiated water intakes and not due to dietary intake of organically bound tritium.

Dose to the cell nucleus from exposure to tritiated pump oil or formaldehyde

A Monte Carlo simulation of tritium decays in a cell composed of two parts, a nucleus and surrounding cytoplasm, was developed to evaluate the beta-radiation dose to the nucleus. A dose modifying factor (DMF), which is a ratio of the average nuclear dose to the whole-tissue dose, after skin-contact exposure of rats to tritiated pump oil or tritiated formaldehyde was estimated. Biokinetic data characterizing the retention of tritium in liver were available in the form of tritium-specific activities and biological half-times for tritiated water and five macromolecular species (DNA, RNA, acid-soluble fraction, acid-insoluble protein, and lipids). The spatial distribution of tissue-free water and macromolecular species in the nucleus and cytoplasm of rat liver cells was based on published data. In the case of exposure to tritiated pump oil, tritium incorporated into lipids provides the largest percentage (60%) of the absorbed dose to the nucleus. For the tritiated-formaldehyde exposure, the tritium dose to the nucleus is overwhelmingly contributed by tritiated water (58%) and in acid-insoluble proteins (40%). For both these tritiated organic exposures, the tritium-labeled DNA has a negligible effect on the DMF. The DMF for the tritiated pump oil and formaldehyde exposures was estimated as 0.81 and 1.05, respectively: the DMF of both exposures was close to unity. Given the other uncertainties in tritium dosimetry, our results suggest that for these skin-contact exposures a uniform distribution of tritium in tissue is an adequate assumption for dosimetry.

Dose contribution from metabolized organically bound tritium after chronic tritiated water intakes in humans

Our earlier study of acute tritiated water intakes in humans has demonstrated that the dose contribution from metabolized organically bound tritium is less than 10% of the body water dose. To further demonstrate that the dose contribution from the organically bound tritium per unit intake of tritiated water is the same, regardless of whether the intake is acute (all at once) or chronic (spread over time), urine samples from six male radiation workers with chronic tritiated water intakes were collected and analyzed for tritium. These workers have a well-documented dose history and a well-controlled tritium bioassay database, providing assurance that their tritium intakes were in the form of tritiated water. Each month for a full calendar year, urine samples were collected from each exposed worker. The monthly concentration of tritiumin-urine for each exposed worker was no lower than 10(4) Bq L(-1) but no higher than 10(5) Bq L(-1). These urine samples were analyzed for tritiated water and organically bound tritium to determine the ratio of these tritiated species in urine. The average ratio of tritiated water to organically bound tritium in urine for each exposed worker was 330 +/- 129 (range, 297-589). In calculating the dose to these workers, we assumed that, under steady-state conditions, the ratio of the specific activity of tritium (3H activity per gH) in the organic matter and water fractions of urine is representative of the ratio of the specific activity of tritium in the organic matter and water fractions of soft tissue. A mathematical model was developed and used to estimate the dose increase from the metabolized organically bound tritium based on the ratio of tritiated water to organically bound tritium in urine. The resulting average dose from the organically bound tritium was 6.9 +/- 3.1% (range, 4.7-9.9%) of the body water dose for the six male workers, and agrees well with the value obtained from our acute tritiated water intakes study in humans. The observed dose contribution from organically bound tritium, relative to body water dose, is in agreement with current recommendations of assigning 10% of total body water dose for organically bound tritium in soft tissues after tritiated water intakes.

A TATA element is required for tRNA promoter activity and confers TATA-binding protein responsiveness in Drosophila Schneider-2 cells

In contrast to yeast and mammalian systems, which depend principally on internal promoter elements for tRNA gene transcription, insect systems require additional upstream sequences. To understand the function of the upstream sequences, we have asked whether the Bombyx mori tRNACAla and tRNASGAla genes, which are absolutely dependent on these sequences in vitro, also require them for transcription in vivo. We introduced wild-type and mutant versions of the Bombyx tRNAAla genes into Drosophila Schneider-2 cells and found that the tRNACAla gene is efficiently transcribed and that its transcription depends strongly on the distal segment of its upstream promoter. In contrast, the tRNASGAla gene is inefficiently transcribed, and this inefficiency results from lack of a specific sequence within the distal tRNACAla upstream promoter. This sequence, 5'-TTTATAT-3', is sufficient to increase the activity of the tRNASGAla promoter to that of the tRNACAla promoter. Moreover, promoters containing the 5'-TTTATAT-3' element are stimulated by increased levels of cellular TATA-binding protein. Together these results indicate that, in insect cells, a TATA-like element is specifically required to form functional TATA-binding protein-containing complexes that promote efficient transcription of tRNA genes.

Regulation of RNA polymerase I-dependent promoters by the hepatitis B virus X protein via activated Ras and TATA-binding protein

The hepatitis B virus (HBV) X protein is essential for viral infectivity, and evidence indicates that it is a strong contributor to HBV-mediated oncogenesis. X has been shown to transactivate a wide variety of RNA polymerase (Pol) II-dependent, as well as RNA Pol III-dependent, promoters. In this study, we have investigated the possibility that X modulates RNA Pol I-dependent rRNA transcription. In both human hepatoma Huh7 and Drosophila Schneider S2 cell lines, X expression stimulated rRNA promoter activity. Extracts prepared from X-expressing cells stably transfected with an X gene also exhibited an increased ability to transcribe the rRNA promoter. The mechanism for X transactivation was examined by determining whether this regulatory event was dependent on Ras activation and increased TATA-binding protein (TBP) levels. Our previous studies have demonstrated that X, and the activation of Ras, produces an increase in the cellular levels of TBP (H.-D. Wang, A. Trivedi, and D. L. Johnson, Mol. Cell. Biol. 17:6838-6846, 1997). Expression of a dominant negative form of Ras blocked the X-mediated induction of the rRNA promoters, whereas expression of a constitutively activated form of Ras mimicked the enhancing effect of X on rRNA promoter activity. When TBP was overexpressed in either Huh7 or S2 cells, a dose-dependent increase in rRNA promoter activity was observed. To analyze whether the increase in TBP was modulating rRNA promoter activity indirectly, by increasing activity of RNA Pol II-dependent promoters, a Drosophila TBP cDNA was constructed with a mutation that eliminated its ability to stimulate RNA Pol II-dependent promoters. Transient expression of wild-type TBP in S2 cells increased the activities of specific RNA Pol I- and Pol II-dependent promoters. Expression of the mutant TBP protein failed to enhance the activity of the RNA Pol II-dependent promoters, yet the protein completely retained its ability to stimulate the rRNA promoter. Furthermore, the addition of recombinant TBP to S2 extracts stimulated rRNA promoter activity in vitro. Together, these results demonstrate that the HBV X protein up-regulates RNA Pol I-dependent promoters via a Ras-activated pathway in two distinct cell lines. The enhanced promoter activity can, at least in part, be attributed to the X- and Ras-mediated increase in cellular TBP, a limiting transcription component.

Multiple initiations in the c-myc replication origin independent of chromosomal location

At supramolecular resolution, DNA synthesis begins at preferred replication origins in the chromosomes of metazoan cells. To characterize one of these origins in detail, the initiation of replication was examined in the HeLa c-myc origin. Polymerase chain reaction (PCR) amplification of size-fractionated nascent chromosomal DNAs revealed multiple replication initiation sites over a 12-kb region spanning the c-myc origin, including the transcribed region and the 5' and 3' flanking DNA of the gene. Two of the start sites for chromosomal replication occurred inside a 2.4-kb region of the origin that exhibits autonomously replicating sequence (ARS) activity. When a plasmid containing the 2.4-kb ARS region was transfected into HeLa cells, PCR mapping of nascent plasmid DNA confirmed that the plasmid replicated semiconservatively and autonomously and that replication did not initiate at random sites but rather began at multiple sites in a limited zone overlapping the c-myc DNA insert. Within the resolution of the PCR assay, the same sites that were used in the chromosomal c-myc origin were used in the 2.4-kb ARS fragment. The locations of replication start sites determined by PCR are considered in the context of other functional and structural elements of the c-myc origin.

Tritium concentrations inside the homes of occupationally exposed workers: dosimetric implications

The average tritiated water concentration in the indoor air of the occupationally exposed worker's residence (55 Bq m(-3), range 53-59 Bq m(-3)) was higher than the indoor air of control residences (0.7 Bq m(-3), range 0.4-0.8 Bq m(-3)). The worker had an average concentration of tritium-in-urine of 30 kBq L(-1) from chronic intakes of occupational levels of tritiated water. Higher residential concentrations of tritiated water vapor were due to tritium transferred by the worker. Urine samples from an adult co-occupant were collected and had tritiated water concentrations between 89 and 345 Bq L(-1). These concentrations were higher than for individuals (range, 6-32 Bq L(-1)) living in other residences having similar outdoor and indoor concentrations of tritiated water in air. The range of measured tritiated water in urine was in agreement with the prediction of biokinetic models for tritium intakes as recommended by the International Commission on Radiological Protection Publication 56. The tritiated water vapor in the indoor air of the exposed worker's residence contributed about 96% of the daily tritium intakes. The annual average tritium dose to the family member (7 microSv) was well below the International Commission on Radiological Protection Publication 60 recommended annual dose limit (1 mSv) for members of the public. We conclude that, for a few members of the public living near a heavy-water research reactor facility, daily intakes of tritium will relate to tritiated water dispersed by the exposed worker, as well as to tritium transported by the atmosphere from the reactor site.

Presacral teratoma presenting with congenital urinary ascites

Congenital teratomas occur most frequently in the sacrococcygeal region. Most grown into a large perineo-sacral swelling that is conspicuous externally. Infrequently, the neoplasm is contained almost entirely within the pelvis in the presacral space. Congenital urinary ascites is observed in patients with obstructive uropathy; posterior urethral valves in a newborn is one of the most prominent causes of urinary ascites. We report a case of presacral teratoma leading to rupture of the urinary bladder due to outflow obstruction and causing urinary ascites. The ascites was drained, the bladder was repaired, and the teratoma was successfully excised. A review of the literature did not reveal any similar case.

Hepatitis B virus X protein induces RNA polymerase III-dependent gene transcription and increases cellular TATA-binding protein by activating the Ras signaling pathway

Our previous studies have shown that the hepatitis B virus protein, X, activates all three classes of RNA polymerase III (pol III)-dependent promoters by increasing the cellular level of TATA-binding protein (TBP) (H.-D. Wang et al., Mol. Cell. Biol. 15:6720-6728, 1995), a limiting transcription component (A. Trivedi et al., Mol. Cell. Biol. 16:6909-6916, 1996). We have investigated whether these X-mediated events are dependent on the activation of the Ras/Raf-1 signaling pathway. Transient expression of a dominant-negative mutant Ras gene (Ras-ala15) in a Drosophila S-2 stable cell line expressing X (X-S2), or incubation of the cells with a Ras farnesylation inhibitor, specifically blocked both the X-dependent activation of a cotransfected tRNA gene and the increase in cellular TBP levels. Transient expression of a constitutively activated form of Ras (Ras-val12) in control S2 cells produced both an increase in tRNA gene transcription and an increase in cellular TBP levels. These events are not cell type specific since X-mediated gene induction was also shown to be dependent on Ras activation in a stable rat 1A cell line expressing X. Furthermore, increases in RNA pol III-dependent gene activity and TBP levels could be restored in X-S2 cells expressing Ras-ala15 by coexpressing a constitutively activated form of Raf-1. These events are serum dependent, and when the cells are serum deprived, the X-mediated effects are augmented. Together, these results demonstrate that the X-mediated induction of RNA pol III-dependent genes and increase in TBP are both dependent on the activation of the Ras/Raf-1 signaling cascade. In addition, these studies define two new and important consequences mediated by the activation of the Ras signal transduction pathway: an increase in the central transcription factor, TBP, and the induction of RNA pol III-dependent gene activity.

Dose contribution from metabolized organically bound tritium after acute tritiated water intakes in humans

Urine samples from eight male radiation workers who had an unplanned acute tritiated water intake were measured for tritium-in-urine up to 300 d post-exposure. During the first month or so post-exposure, these individuals increased their fluid intakes to accelerate the turnover rate of tritium in the body for dose mitigation. Their daily fluid intakes reverted to normal levels in the latter period of the study. A non-linear regressional analysis of the tritium-in-urine data showed that the average biological half-life of tritium in body water, with standard deviation, was 6.3 +/- 1.0 d (range, 5.0-8.1 d) and 8.4 +/- 2.0 d (range, 6.2-12.8 d) during the respective periods of increased fluid intake and the later period of normal fluid intake. A longer term component of tritium excretion was also observed with average biological half-life of 74 +/- 18 d (range, 58-104 d), indicating the incorporation of tritium, and its retention, in the organic fractions of the body. A mathematical model was developed and used to estimate the dose increase from the metabolized organically bound tritium on the basis of the kinetics of tritium-in-urine. The model accounts for a change in the rates of urinary excretion caused by variable fluid intakes. The average dose to the body, for the eight male workers, due to the metabolized organically bound tritium was estimated to be 6.2 +/- 1.3% (range, 3.5% to 8.9%) of the committed effective dose due to tritium in the body water. This value for the dose increase from organically bound tritium is in the range of the current recommendations of the International Commission on Radiological Protection, i.e., organically bound tritium incorporated into the body contributes about 10% of the dose to the body water following tritiated water intakes.

An RNA polymerase III-defective mutation in TATA-binding protein disrupts its interaction with a transcription factor IIIB subunit in drosophila cells

A subunit of the Drosophila RNA polymerase III transcription factor IIIB (TFIIIB) complex has been identified using antibodies directed against the analogous human protein, hIIIB90. This protein has an apparent molecular mass of 105 kDa and has been designated dTAFIII105. Drosophila S-2 cell extracts that were immunodepleted of dTAFIII105 were substantially reduced in their capacity to support tRNA gene transcription. A protein (far Western) blot analysis revealed that dTAFIII105, present in a TFIIIB fraction, directly interacts with TATA-binding protein (TBP). Coimmunoprecipitation assays demonstrated that this protein associates with TBP in S-2 cell extracts. Our previous studies have identified a mutation at position 332 within Drosophila TBP that changes a highly conserved arginine residue to a histidine residue, which renders it specifically defective in its ability to support RNA polymerase III transcription in S-2 cells (Trivedi, A., Vilalta, A., Gopalan, S., and Johnson, D. L. (1996) Mol. Cell. Biol. 16, 6909-6916). We further demonstrate that extracts prepared from a stable cell line expressing epitope-tagged wild-type TBP exhibit an increase in tRNA gene transcription, whereas extracts derived from cells expressing the mutant TBP protein do not. Coimmunoprecipitation assays and far Western blot analysis demonstrate that this mutation in TBP abolishes its ability to stably interact with dTAFIII105. Thus, we have identified both a Drosophila protein that is directly associated with TBP in the TFIIIB complex, dTAFIII105, and an amino acid residue within the highly conserved carboxyl-terminal region of TBP that is critical for dTAFIII105-TBP interactions.

TATA-binding protein is limiting for both TATA-containing and TATA-lacking RNA polymerase III promoters in Drosophila cells

We have investigated the role of the TATA-binding protein (TBP) in modulating RNA polymerase (Pol) III gene activity. Epitope-tagged TBP (e-TBP) was both transiently and stably transfected in Drosophila Schneider S-2 cells to increase the total cellular level of TBP. Analysis of the transcripts synthesized from cotransfected tRNA and U6 RNA genes revealed that both types of RNA Pol III promoters were substantially stimulated by an increase in e-TBP in a dose-dependent manner. Furthermore, a TBP-dependent increase in the levels of endogenous tRNA transcripts was produced in the stable line induced to express the e-TBP. We further determined whether the ability of increased TBP to induce RNA Pol III gene expression was due to a direct effect of increased TBP complexes on RNA Pol III gene promoters or an indirect consequence of enhanced expression of RNA Pol II genes. A TBP expression plasmid (e-TBP332), containing a mutation within the highly conserved carboxy-terminal domain, was both transiently and stably transfected into S-2 cells. e-TBP332 augmented the transcription from two RNA Pol II gene promoters indistinguishably from that observed when e-TBP was expressed. In contrast, e-TBP332 was completely defective in its ability to stimulate either the tRNA or U6 RNA gene promoters. In addition, increasing levels of a truncated TBP protein containing only the carboxy-terminal region failed to induce either the tRNA or U6 RNA gene promoter, whereas it retained its ability to stimulate an RNA Pol II promoter. Thus, the TBP-dependent increase in RNA Pol II gene activity is not sufficient for enhanced RNA Pol III gene transcription; rather, a direct effect on RNA Pol III promoters is required. Furthermore, these results provide the first direct evidence that the amino-terminal region of TBP is important for the formation or function of TBP-containing complexes utilized by TATA-less and TATA-containing RNA Pol III promoters. Together, these studies demonstrate that TBP is limiting for the expression of both classes of RNA Pol III promoters in Drosophila cells and implicate an important role for TBP in regulating RNA Pol III gene expression.

Proximal jejunal obstruction due to eosinophilic gastroenteritis

Eosinophilic enteritis or gastroenteritis is a rare disease characterised by tissue eosinophilia which can affect different layers of bowel wall. It can affect any area of gastrointestinal tract from the esophagus to the rectum, although stomach and small intestine are sites most frequently reported. It is important to recognize this disease early and institute the necessary treatment. An eight year old girl presented with acute intestinal obstruction. Exploration revealed a structure of proximal jejunum. Histopathology demonstrated eosinophilic jejunitis. The case is reported owing to this rarity and relevant literature is reviewed.

GRIP1, a novel mouse protein that serves as a transcriptional coactivator in yeast for the hormone binding domains of steroid receptors

The yeast two-hybrid system was used to isolate a clone from a 17-day-old mouse embryo cDNA library that codes for a novel 812-aa long protein fragment, glucocorticoid receptor-interacting protein 1 (GRIP1), that can interact with the hormone binding domain (HBD) of the glucocorticoid receptor. In the yeast two-hybrid system and in vitro, GRIP1 interacted with the HBDs of the glucocorticoid, estrogen, and androgen receptors in a hormone-regulated manner. When fused to the DNA binding domain of a heterologous protein, the GRIP1 fragment activated a reporter gene containing a suitable enhancer site in yeast cells and in mammalian cells, indicating that GRIP1 contains a transcriptional activation domain. Overexpression of the GRIP1 fragment in mammalian cells interfered with hormone-regulated expression of mouse mammary tumor virus-chloramphenicol acetyltransferase gene and constitutive expression of cytomegalovirus-beta-galactosidase reporter gene, but not constitutive expression from a tRNA gene promoter. This selective squelching activity suggests that GRIM can interact with an essential component of the RNA polymerase II transcription machinery. Finally, while a steroid receptor HBD fused with a GAL4 DNA binding domain did not, by itself, activate transcription of a reporter gene in yeast, coexpression of this fusion protein with GRIP1 strongly activated the reporter gene. Thus, in yeast, GRIP1 can serve as a coactivator, potentiating the transactivation functions in steroid receptor HBDs, possibly by acting as a bridge between HBDs of the receptors and the basal transcription machinery.

Occupational levels of radiation exposure induce surface expression of interleukin-2 receptors in stimulated human peripheral blood lymphocytes

Interleukin-2 (IL-2) is a cytokine responsible for a variety of immune and non-immune stimulatory and regulatory functions, including the activation and stimulation of cytotoxic cells able to recognize and kill human tumour cells and T-cell proliferation and differentiation. We show that low doses of radiation, in the range commonly received by atomic radiation workers or as a result of minor medical diagnostic procedures (0.25 to 10 mGy), stimulate the expression of IL-2 receptors (IL-2R) on the surface of peripheral blood lymphocytes (PBL) taken from normal human donors. This stimulated surface expression after in vitro irradiation is an indirect effect, resulting from the secretion into the medium of a soluble factor from the irradiated cells. This factor can also stimulate IL-2R surface expression in unirradiated cells. Consequently, radiation stimulation of IL-2R expression in a large population of PBL shows a triggered-type response rather than being proportional to dose. These results demonstrate that normal human cells can respond to doses of radiation in the range of common occupational or medical exposures. The data also demonstrate a possible defence mechanism against environmental stress by which a radiation-exposed cell can use an indirect signalling mechanism to communicate with and influence the biological processes in an unexposed cell.

Inhibitory effects of naltrexone on the induction of parental behavior in juvenile rats

Juvenile rats are rapidly responsive to pups soon after weaning, displaying maternal-like behaviors such as licking, retrieving, grouping, and crouching over pups. As juveniles reach 30 days of age, they become less responsive to pups and show increased latencies to display the same parental behaviors. In light of previous data implicating opiates in the display of ongoing maternal behavior, we administered naltrexone, a long-acting opiate antagonist, beginning 5 and 9 days prior to and continuing throughout the period of behavioral testing, which started at 26 or 30 days of age. Male and female juveniles treated with 10 mg/kg of naltrexone SC for 9 days (days 21 to 29 of age) prior to and during behavioral testing (days 30 to 37) showed longer latencies to retrieve, group, and crouch over pups than did the vehicle-injected controls. These results suggest that opioids may have a stimulatory role in parental behavior during this prepubertal period.